Surv Ophthalmol. 2021 Dec 08. pii: S0039-6257(21)00220-4. [Epub ahead of print]
Glaucoma is a chronic optic neuropathy that creates a significant burden on public health. Oxidative stress is hypothesised to play a role to glaucoma progression, and its reduction is being analysed as a therapeutic target. Dietary antioxidants play a crucial role in helping provide insight into this hypothesis. We reviewed 71 trials, interventional, I -vivo and I -vitro, including 11 randomised controlled trials, to determine if adjunctive nutritional supplementation could lead to a reduction in oxidative stress and prevent glaucomatous progression. Many laboratory findings show that vitamins and natural compounds contain an abundance of intrinsic antioxidative, neuroprotective and vasoprotective properties that show promise in the treatment and prevention of glaucoma. Although there is encouraging early evidence, most clincial findings are inconclusive. The group of B vitamins appear to have the greatest amount of evidence. Other compounds such as flavonoids, carotenoids, curcumin, saffron, CoQ10, Ggngko Biloba and Resveratrol however warrant further investigation in glaucoma patients. Studies of these antioxidants and other nutrients could create adjunctive or alternative preventative and treatment modalities for glaucoma to those currently available.
Keywords: AA, Ascorbic acid; ARMD, Age Related Macular Degeneration; CoQ10, Coenzyme Q10; GON, Glaucomatous Optic Neuropathy; Hcy, Homocysteine; IOP, Intraocular pressure; NO, Nitric Oxide; NOS, Nitric Oxide Synthase; NTG, Normal Tension Glaucoma; POAG, Primary open angle Glaucoma;PEXG, Exfoliation Glaucoma; PVD Primary vascular dysregulation; RGC, Retinal Ganglion Cells; ROS, Reactive Oxygen Species; SC, Schlemm's Canal; TM Trabecular Meshwork; Vitamins, Nutrients, Glaucoma, Supplements, Reactive Oxygen Species, Open Angle Glaucoma, Trabecular Meshwork, Retinal Ganglion Cells, Oxidative Stress. Abbreviations